[sue k]

I WAS OUTSIDE YESTERDAY LOOKING AT MY FLOWER GARDEN IT ISN'T DOIN WELL BECAUSE OF ALL THE RAIN. MY DAUGHTER GAVE ME A MARIGOLD PLANT FOR MOTHERS DAYGIFT IN 1988. EVER SINCE I'VE BEEN PICKING THEM AND DRYING THEM OUT. I GET TONS OF SEEDS. WELL I WENT TO TURN AROUD AND TRIPPED OVER A TOY ONE OF THE KIDS LEFT OUT. I SPUN AROUND SO HARD AND LANDED ON MY BUTT. I TRIED TO GET UP AND THE PAIN SHOT UP MY LEG. I COULDN'T OFF OF THE GROUND. I SCREAMED FOR MY HUSBAND. IT STARTED SWELLING SO FAST BY THE TIME HE GOT THERE IT WAS LIKE A BALLOON & PURPLE. THEY GOT ME INTO THE CAR AND I SCREAMED ALL THE WAY TO THE HOSPITAL. WELL I BROKE MY KNEE IN TWO PLACES. OF COURSE ITS THE LEG WITH THE RSD. IT HURTS SO BAD, THE PAIN CLINIC DOUBLED MY DOSE OF OXYCODONE. i GO TO THE ORTHO DOC ON MONDAY. THEY SAID I MIGHT NEED AN OPERATION. I AM SO SCARED. PLEASE PRAY FOR ME. THANKYOU,

SUE K

[Abbie]

( ( ( ( ( Sue ) ) ) ) )

I'm sorry to hear of your accident and bone break...

Sending soft gentle hugs your way.

Also sending prayer for quick healing and low pain levels...


Abbie

[loretta]

Hi Sue,
I am so very very sorry. We have enough to deal with, let alone breaking a bone.
I would encourage you to get the best Orthopedic Knee Dr. possible, even if it means going to another state, if you can afford it. I have some names of Drs. on national sports level with top team Drs. My husband here in Scottsdale,Arizona had the Diamondbacks Team surgeon for hand,arm. I went to Oregon to the University of Oregon Sports Injury Dr. Saw the Knee Dr. at one time when we lived there and went back and was diagnosed with RSD with the Hand Dr. in less than a minute. Have met Kobe Bryants Knee Dr. I'm now saying these names to bragg, but after my Mom died from a bad Dr., I am a little extreme in looking for the best Dr. for whatever part of the body we need.
Some of the others on here have more experience in the preparations before surgery to prevent spread. Ask for help in that specific area and you'll get some real good suggestions.
Please know we are all thinking of you during this difficult time. Please keep in touch and let us know how things are progressing. Your friend, loretta

[Dew58]

is around you ( ( ( ( ( Sue ) ) ) ) )..

I am so sorry you are in such a painful place. I will keep you and yours in my thoughts and prayers. Try to relax, take your meds, and just know you are surrounded by a circle of love.


Dew

[fmichael]

Dear Sue -

I am so, so sorry to hear this. I agree that immediate pain control is the thing to be done first.

First things first, if the oxycondone is not doing the job, even at the higher dose, you may want to ask your PM doc about a stronger narcotic than oxycodone, say methadone, Meperidine (demerol hydrochloride syrup), or even oral Dilaudid (hydromorphone). Just make sure you get an appropriate prescription med to counteract what could otherwise be an immediate shutdown of your GI track: lately they seem to be doing a lot with very small doses of opioid antaganists, which keep the gut working but aren't enough it leach into the blood stream and thereby counteract the property of the opioid in the first place. I was regularly using Naloxone Hydrocloride (Narcan) taken via an oral syringe, until the price went from between around $140 a case - roughly a 40 day supply - to just under $800 in less than a year (it's generic, but there's only one manufacturer) so I went off in favor of over the counter products, only to have my combination of Oxcycontin/oxcycodone basically stop working, at which point I was switched to 30 mg. of methdone a day, and a couple a weeks later, I had two hernias to show for it!

I'm probably preaching to the choir on this one, but this is what I have learned in the past few weeks since it became apparent I needed surgery for the double hernias: putting aside the question of the appropriate sugeon, the procedure as a whole has to be done in a hospital where you can get a pre-op consult with the anesthesiologist to go over your drug list and the recommendation of your pm doc. concerning the anesthetic component of the procedure, blocks, continuous regional anasthesia, etc. Turns out, it's a simple yes or no question on whether such consults are available. If they aren't, the advice I've gotten from a very well regarded general surgeon in a "regional medical center" was that I had to move on down the road to a university medical center or other tertiary treatment facility. Otherwise, what happens at many places - including his hospital - is that you'll have an anesthesiologist assigned the day before the procedure, who will just be looking at your list of meds a few minutes before they bring you in. My internist told me that in that scenario, he was personally familiar with situations where such randomly drawn anesthiosiolgists, looking at lists of prescription drugs far shorter than my own, had thrown up their hands and refused to go forward, not being 100% sure how any particular general anesthetic would react to all the meds the patient was on. And that's not even talking about having the special precautions taken that are appropriate for a CRPS patient entering surgery!

I'm sorry for going on so, but I hope that some of this information may be news to you and therefore potentially useful.

You are very much in my thoughts. As well I'm sure, of all of the old-timers on this board, and then some.

Mike

ps Dubious is 100% correct in his comment below. There is no reason to wait until surgery to attack the barrage of pain signalling current hitting the dorsal horn of your spinal cord for which pain killers provide no protection at all. Perhaps a hard hitting series of bilateral lumbar sympathetic blocks, where even though your CRPS is chronic -on account of which there may be little or no pain signalling "from" the leg even though that's where it is surely "felt" - the knee issue is brand new, and should be responsive to blocks for the same reason that prophylactic blocks of one sort or another help prevent spread in the OR.

[Dubious]

Originally Posted by fmichael

Dear Sue -

I am so, so sorry to hear this. I agree that immediate pain control is the thing to be done first.

First things first, if the oxycondone is not doing the job, even at the higher dose, you may want to ask your PM doc about a stronger narcotic than oxycodone, say methadone, Meperidine (demerol hydrochloride syrup), or even oral Dilaudid (hydromorphone). Just make sure you get an appropriate prescription med to counteract what could otherwise be an immediate shutdown of your GI track: lately they seem to be doing a lot with very small doses of opioid antaganists, which keep the gut working but aren't enough it leach into the blood stream and thereby counteract the property of the opioid in the first place. I was regularly using Naloxone Hydrocloride (Narcan) taken via an oral syringe, until the price went from between around $140 a case - roughly a 40 day supply - to just under $800 in less than a year (it's generic, but there's only one manufacturer) so I went off in favor of over the counter products, only to have my combination of Oxcycontin/oxcycodone basically stop working, at which point I was switched to 30 mg. of methdone a day, and a couple a weeks later, I had two hernias to show for it!

I'm probably preaching to the choir on this one, but this is what I have learned in the past few weeks since it became apparent I needed surgery for the double hernias: putting aside the question of the appropriate sugeon, the procedure as a whose has to be done in a hospital where you can get a pre-op consult with the anesthesiologist to go over your drug list and the recommendation of your pm doc. concerning the anesthetic component of the procedure, blocks, continuous regional anasthesia, etc. Turns out, it's a simple yes or no question on whether such consults are available. If they aren't, the advice I've gotten from a very well regarded general surgeon in a "regional medical center" was that I had to move on down the road to a university medical center or other tertiary treatment facility. Otherwise, what happens at many places - including his hospital - is that you'll have an anesthesiologist assigned the day before the procedure, who will just be looking at your list of meds a few minutes before they bring you in. My internist told me that in that scenario, he was personally familiar with situations where such randomly drawn anesthiosiolgists, looking at lists of prescription drugs far shorter than my own, had thrown up their hands and refused to go forward, not being 100% sure how any particular general anesthetic would react to all the meds the patient was on. And that's not even talking about having the special precautions taken that are appropriate for a CRPS patient entering surgery!

I'm sorry for going on so, but I hope that some of this information may be news to you and therefore potentially useful.

You are very much in my thoughts. As well I'm sure, of all of the old-timers on this board, and then some.

Mike

All the advice sounds good to me. I would only add that you should talk to our PM doc about the efficacy of epidurals, ganglion blocks, etc., anything to keep the pain signals from hitting the spinal cord.

Good luck, happy thoughts and prayers to you!

[hope4thebest]

Hi Sue,
I'm so sorry for the terrible ordeal and for the pain you are experiencing! Let's hope you will not need surgery !!

If you do need an operation, it will be comforting to you if you know that your medical team doctors (anasthesiologist, pain management, surgeon,, etc.) are all on the same page and that there is a plan in place for you pre-op and post-op!! That will make you feel more confident and assured going into surgery! It's always a good idea for you and your family to make a list of questions,and any concern you might have about pain control, etc. That will ease your mind as well....
But here's hoping you will not need surgery!!!!

Thinking of you,
Hope4thebest

[bobber]

Prayers are on their way,,,,,,,,,,,,

[sue k]

THANKS EVEYONE. iTALKED TO MY PAIN CLINIC AND IF I NEED THE OPERATION, THEY WILL BE INVOLVED IN EVERY STEP OF THE WAY. I JUST HOPE THE RSD DOESN'T SPREAD. MY POOR HUSBAND IS IN SO MUCH PAIN FROM LIFTING ME UP, GETTING ME TO THE BATHROOM ,AND INTO THE ONLY CHAIR I CAN SIT IN. HE HAS HAD 3 SPINAL FUSIONS AND I FEEL DO BAD FOR HIM. WELL I HAVE TO GET BACK TO THE RECLINER. THANKS AGAIN TO ALL OF YOU.

SUE K

[daniella]

I am so sorry about what happened. You will be in my thoughts as well. I'm really glad your pain doctor is aware as well. Try to take one day at a time though I know that is very hard and take care.